| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | GUARDIAN | $23K | $1K | $24K | 8.48% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK INC | 6 TOWER PL ALBANY, NY 12203 | GUARDIAN | $82 | — | $82 | 0.03% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | MUTUAL OF OMAHA INSURANCE COMPANY | $19K | — | $19K | 11.00% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 8.38% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | COMPANION LIFE INSURANCE COMPANY | $12K | — | $12K | 25.00% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | MUTUAL OF OMAHA INSURANCE COMPANY | $9K | — | $9K | 20.00% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | MUTUAL OF OMAHA INSURANCE COMPANY | $11K | — | $11K | 25.00% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 14.00% |
| BOLLINGER INC3 Filed as: BOLLINGER INC. | 200 JEFFERSON PARK WHIPPANY, NJ 07981 | MUTUAL OF OMAHA INSURANCE COMPANY | $878 | — | $878 | 14.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE INC. EIN 23-7391136 INSURANCE PROVIDER | Float revenue; Other services; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1 LIBERTY PLAZA 165 BROADWAY NEW YORK, NY 10006 | $1.3M |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 1,120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 801 | $358K |
| Dental | GUARDIAN | 666 | $287K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 798 | $51K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 1,120 | $74K |
| Short-term disability(3 contracts, 2 carriers) | GUARDIAN | 1,091 | $502K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 88 | $43K |
| Prescription drug | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 801 | $168K |
| Stop-loss / reinsurancereinsurance(2 contracts) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 801 | $527K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 1,120 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,120 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.